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Trends in Cancer
This journal offers authors two options (open access or subscription) to publish research

Apr 01, 2022

Volume 8Issue 4p259-344, e1-e2
Special issue: Cancer health disparities
Decades of cancer research have led to remarkable treatment breakthroughs that have yielded major responses in patients with a variety of cancers, but not all sections of society have benefitted equally from these advances. This special issue of Trends in Cancer examines the factors that underpin cancer health disparities in racial and ethnic minorities and other underserved populations. Articles describe the multiple types of determinants, including biological/genetic, environmental, behavioral, health care, and social determinants that contribute to cancer health disparities. The cover depicts inequities in cancer incidence and survival based on biological factors and genetic ancestry (a tree with healthy growth versus that of a dying tree), race and ethnicity, environmental exposures and quality medical care. The left side of the image depicts factors that are often associated with a lower risk of cancer and a higher survival rate from cancer, while the right side of the image depicts factors that can drive health disparities. Cover design by Kip Lyall....
Decades of cancer research have led to remarkable treatment breakthroughs that have yielded major responses in patients with a variety of cancers, but not all sections of society have benefitted equally from these advances. This special issue of Trends in Cancer examines the factors that underpin cancer health disparities in racial and ethnic minorities and other underserved populations. Articles describe the multiple types of determinants, including biological/genetic, environmental, behavioral, health care, and social determinants that contribute to cancer health disparities. The cover depicts inequities in cancer incidence and survival based on biological factors and genetic ancestry (a tree with healthy growth versus that of a dying tree), race and ethnicity, environmental exposures and quality medical care. The left side of the image depicts factors that are often associated with a lower risk of cancer and a higher survival rate from cancer, while the right side of the image depicts factors that can drive health disparities. Cover design by Kip Lyall.

Editorial

  • Every patient

    • Danielle T. Loughlin
    Cancer research is grounded in the mission to improve the lives of patients with cancer – every patient. Decades of basic cancer research have led to remarkable treatment breakthroughs that have yielded major responses in patients with a variety of cancers, but not all sections of society have benefitted equally from these advances. Cancer health disparities continue to persist between high- and low-income countries, as well as rural communities as compared to those living in urban environments.

TrendsTalk

  • On the path to equity in cancer research and care

    Cancer health disparities can be seen across a myriad of populations, each presenting with their own unique challenges to equity. We ask experts what they see as the challenges and opportunities for reducing disparities in particular underserved and minority populations.

Science & Society

    Featured Article
  • Role of financial toxicity in perpetuating health disparities

    • Kanan Shah,
    • S. Yousuf Zafar,
    • Fumiko Chino
    Rising costs of cancer care drive patient financial toxicity (FT) that perpetuates known health disparities in access and quality cancer treatment. This Review discusses how FT is a barrier to cancer research and treatment, and discusses potential solutions to improve affordability and reduce healthcare disparities for our patients.
  • New York’s Polyethnic-1000: a regional initiative to understand how diverse ancestries influence the risk, progression, and treatment of cancers

    • Nicolas Robine,
    • Harold Varmus
    Research consortia can help to repair deficiencies in knowledge about the influence of inherited genetic diversity on disease. The New York Genome Center (NYGC) recently established Polyethnic-1000 (P-1000), a multi-institutional collaboration to study hereditary factors affecting several types of cancer. Here, we describe its rationale, organization, development, current activities, and prospects.
  • Featured Article
  • Understanding the role of sex hormones in cancer for the transgender community

    • Sarah S. Jackson,
    • Kate Z. Nambiar,
    • Stewart O’Callaghan,
    • Alison May Berner
    Sex hormones are crucial for the body’s development and function. Therefore, many transgender people seek hormone therapy as part of their transition. However, sex hormones modulate cancer risk. Studying sex hormones in cisgender and transgender populations will improve our knowledge of their biological role in cancer and reduce health disparities.
  • Understanding how genetic ancestry may influence cancer development

    • Brittany D. Lord,
    • Rachel N. Martini,
    • Melissa B. Davis
    Of the multifactorial determinants that lead to cancer health disparities among race groups, quantified genetic ancestry has begun to expand our knowledge beyond self-reported race. However, it is essential to study these biological determinants in the context of social determinants to truly improve clinical tools and achieve equitable survival outcomes.
  • A tipping point in cancer epidemiology: embracing a life course exposomic framework

    • Rosalind J. Wright,
    • Heidi A. Hanson
    The pathogenesis of multifactorial malignant diseases, with variable onset, severity, and natural history, reflects development-specific exposures and individual responses to these exposures influenced by underlying genetic predisposition. Embedded in life course theory, exposomics provides a framework to more fully elucidate how environmental factors alter cancer risk, disease course, and response to treatment across the lifespan.
  • Featured Article
  • Disparate groups share cancer disparities

    • George J. Weiner,
    • Robert A. Winn
    Due to historical and structural factors, underserved rural and racial/ethnic minorities suffer a disproportionate cancer burden based in part on common disparities they share. The time is ripe for cancer researchers to engage with these underserved populations to build trust in science and improve care for those they serve.

Forum

Opinion

  • Redefining precision cancer prevention to promote health equity

    • Eboneé N. Butler,
    • Asad Umar,
    • Brandy M. Heckman-Stoddard,
    • Kathryn A. Kundrod,
    • Lisa B. Signorello,
    • Philip E. Castle
    Precision cancer prevention as it is currently envisioned is a targeted, molecular-based approach to intercept carcinogenesis before cancer develops or before it becomes untreatable. Unfortunately, due to systemic biases, current precision cancer prevention interventions might not be effective in all populations, especially in minoritized communities. In addition, not all cancer risk is attributable to genetic or even biological factors, but includes social determinants of health (SDH). Here, we propose a broader framework for precision cancer prevention, anchored in optimizing the benefits to harms for all people.
  • The spectrum of sex differences in cancer

    • Joshua B. Rubin
    Open Access
    Sex differences in cellular and systems biology have been evolutionarily selected to optimize reproductive success in all species with little (sperm) and big (ova) gamete producers. They are evident from the time of fertilization and accrue throughout development through genetic, epigenetic, and circulating sex hormone-dependent mechanisms. Among other effects, they significantly impact on chromatin organization, metabolism, cell cycle regulation, immunity, longevity, and cancer risk and survival.

Review

  • Immune response and inflammation in cancer health disparities

    • Maeve Kiely,
    • Brittany Lord,
    • Stefan Ambs
    Cancer death rates vary among population groups. Underserved populations continue to experience an excessive burden of lethal cancers that is largely explained by health-care disparities. However, the prominent role of advanced-stage disease as a driver of cancer survival disparities may indicate that some cancers are more aggressive in certain population groups than others. The tumor mutational burden can show large differences among patients with similar-stage disease but differences in race/ethnicity or residence.
  • Diversity upon diversity: linking DNA double-strand break repair to blood cancer health disparities

    • Jason N. Sterrenberg,
    • Melissa L. Folkerts,
    • Valeria Rangel,
    • Sarah Eugenie Lee,
    • Nicholas R. Pannunzio
    Chromosomal translocations arising from aberrant repair of multiple DNA double-strand breaks (DSBs) are a defining characteristic of many cancers. DSBs are an essential part of physiological processes in antibody-producing B cells. The B cell environment is poised to generate genome instability leading to translocations relevant to the pathology of blood cancers. These are a diverse set of cancers, but limited data from under-represented groups have pointed to health disparities associated with each.
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